Joint and Soft Tissue Injection

Injection techniques are helpful for diagnosis and therapy in a wide variety of musculoskeletal conditions. Diagnostic indications include the aspiration of fluid for analysis and the assessment of pain relief and increased range of motion as a diagnostic tool. Therapeutic indications include the delivery of local anaesthetics for pain relief and the delivery of corticosteroids for suppression of inflammation. Side effects are few; but may include tendon rupture; infection; steroid flare; hypopigmentation; and soft tissue atrophy. Injection technique requires knowledge of anatomy of the targeted area and a thorough understanding of the agents used. In this overview; the indications; contraindications; potential side effects; timing; proper technique; necessary materials; pharmaceuticals used and their actions; and post-procedure care of patients are presented

Diagnostic and Therapeutic Injection of the Shoulder Region

The shoulder is the site of multiple injuries and inflammatory conditions that lend themselves to diagnostic and therapeutic injection. Joint injection should be considered after other therapeutic interventions such as non-steroidal anti-inflammatory drugs; physical therapy; and activity-modification have been tried. Indications for glenohumeral joint injection include osteoarthritis; adhesive capsulitis; and rheumatoid arthritis. For the acromioclavicular joint; injection may be used for diagnosis and treatment of osteoarthritis and distal clavicular osteolysis. Subacromial injections are useful for a range of conditions including adhesive capsulitis; subdeltoid bursitis; impingement syndrome; and rotator cuff tendinosis. Scapulothoracic injections are reserved for inflammation of the involved bursa. Persistent pain related to inflammatory conditions of the long head of the biceps responds well to injection in the region. The proper technique; choice and quantity of pharmaceuticals; and appropriate follow-up are essential for effective outcomes